Individual
JARED SUNDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D, L.D.
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 273-5188
Mailing address
307 6TH AVE, PROCTOR, MN 55810-1658
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3168
MN
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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